Your browser doesn't support javascript.
loading
The impact of general anesthesia on child development and school performance: a population-based study.
Schneuer, Francisco J; Bentley, Jason P; Davidson, Andrew J; Holland, Andrew Ja; Badawi, Nadia; Martin, Andrew J; Skowno, Justin; Lain, Samantha J; Nassar, Natasha.
Afiliação
  • Schneuer FJ; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW, Australia.
  • Bentley JP; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW, Australia.
  • Davidson AJ; Anaesthesia and Pain Management Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
  • Holland AJ; Discipline of Child and Adolescent Health, The Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
  • Badawi N; Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia.
  • Martin AJ; School of Education, University of New South Wales, Sydney, NSW, Australia.
  • Skowno J; Discipline of Child and Adolescent Health, The Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
  • Lain SJ; Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, NSW, Australia.
  • Nassar N; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW, Australia.
Paediatr Anaesth ; 28(6): 528-536, 2018 06.
Article em En | MEDLINE | ID: mdl-29701278
ABSTRACT

BACKGROUND:

There has been considerable interest in the possible adverse neurocognitive effects of exposure to general anesthesia and surgery in early childhood.

AIMS:

The aim of this data linkage study was to investigate developmental and school performance outcomes of children undergoing procedures requiring general anesthesia in early childhood.

METHODS:

We included children born in New South Wales, Australia of 37+ weeks' gestation without major congenital anomalies or neurodevelopmental disability with either a school entry developmental assessment in 2009, 2012, or Grade-3 school test results in 2008-2014. We compared children exposed to general anesthesia aged <48 months to those without any hospitalization. Children with only 1 hospitalization with general anesthesia and no other hospitalization were assessed separately. Outcomes included being classified developmentally high risk at school entry and scoring below national minimum standard in school numeracy and reading tests.

RESULTS:

Of 211 978 children included, 82 156 had developmental assessment and 153 025 had school test results, with 12 848 (15.7%) and 25 032 (16.4%) exposed to general anesthesia, respectively. Children exposed to general anesthesia had 17%, 34%, and 23% increased odds of being developmentally high risk (adjusted odds ratio [aOR] 1.17; 95% CI 1.07-1.29); or scoring below the national minimum standard in numeracy (aOR 1.34; 95% CI 1.21-1.48) and reading (aOR 1.23; 95% CI 1.12-1.36), respectively. Although the risk for being developmentally high risk and poor reading attenuated for children with only 1 hospitalization and exposure to general anesthesia, the association with poor numeracy results remained.

CONCLUSION:

Children exposed to general anesthesia before 4 years have poorer development at school entry and school performance. While the association among children with 1 hospitalization with 1 general anesthesia and no other hospitalization was attenuated, poor numeracy outcome remained. Further investigation of the specific effects of general anesthesia and the impact of the underlying health conditions that prompt the need for surgery or diagnostic procedures is required, particularly among children exposed to long duration of general anesthesia or with repeated hospitalizations.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Logro / Desenvolvimento Infantil / Desempenho Acadêmico / Anestesia Geral Limite: Child / Child, preschool / Female / Humans / Male País como assunto: Oceania Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Logro / Desenvolvimento Infantil / Desempenho Acadêmico / Anestesia Geral Limite: Child / Child, preschool / Female / Humans / Male País como assunto: Oceania Idioma: En Ano de publicação: 2018 Tipo de documento: Article